Monday, July 25, 2011

DNA Sequencing or Magnetic Resonance Imaging MRI

Today, one of the most common tests ordered in the United States is a Magnetic Resonance Image or MRI. These images are typically ordered of a specific body part or region. The cost of this type of test is variable ranging from $800 to over $3000 and produces exquisite information anatomic images.

MRI of Torn Rotator Cuff

An MRI, however, gives the clinician no information about the patients systemic physiology or potential underlying risk factors. If DNA sequencing can follow Moore's Law from computer science, then the cost should drop to $1000 within five years or perhaps less. Databases are already being created with numbers reaching over 100,000 patients. As the cost drops, physicians will begin ordering these tests almost as often as MRIs and we will then see dramatic shifts in the practice of medicine. The natural history (what happens if no intervention occurs) is different for different patients. We may be able to predict with DNA sequencing who will recover WITHOUT any specific or expensive treatment. We also may be able to predict which patients will require aggressive treatment. The era of personalized genomic medicine will have arrived. This has broad implications for reducing the cost of care if implemented appropriately.